Femoral Head and Neck Excision

Harper, T. A.

doi:10.1016/j.cvsm.2017.03.002

Cited by 39 publications

(59 citation statements)

References 27 publications

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“…Após a ostectomia da cabeça e colo femoral, além dos exercícios passivos, há indicação de exercícios ativo-assistidos e ativos nas primeiras sessões de fisioterapia com o intuito de evitar a formação excessiva de tecido fibroso periarticular em decorrência do processo cicatricial. A proliferação do tecido fibroso é uma das principais complicações pós--operatória e pode ocasionar limitação e dor durante movimentação [9].…”

Section: Discussionunclassified

Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy

Colveiro

Rauber

Ripplinger

et al. 2020

Acta Scientiae. Vet.

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Background: The goals of physical therapy are to maximize functional recovery, improve mobility, and restore well-being and quality of life. In the veterinary literature, there is a dearth of data on physical therapy in small animal practice. Therefore, this study aimed to identify the main neurological and orthopedic diseases in canine and feline patients seen at the physical therapy service of an animal hospital. Concomitantly, we collected demographic and clinical information on patients, including sex, breed, physical therapy modalities, number and frequency of physical therapy sessions, duration of treatment, and rate of functional recovery.Materials, Methods & Results: The records of animals with neurological and orthopedic diseases seen at the Physical Therapy department of a university-affiliated animal hospital were reviewed. The animals were divided into two groups: I) dogs and cats with neurological diseases and II) dogs and cats with orthopedic diseases. Both groups were distributed according to species, age, sex and race. Dogs and cats were classified into three age groups: puppies (≤ 1 year old), adults (> 1 year and ≤ 10 years old) and elderly (> 10 years old). A total of 384 records were retrieved, of which 370 (96.4%) were of dogs and 14 (3.6%) of cats. Neurological cases accounted for 66% of the total (n = 253), with 243 cases in dogs (96%) and 10 in cats (4%). Among orthopedic cases (n = 131, accounting for the remaining 34%), 127 were in dogs (97%) and only 4 in cats (3%). In the neurological dysfunction group, intervertebral disc disease (72.4%) was the most common diagnosis. Among the orthopedic disorders, femur fracture (23.1%) was most prevalent. In group I (neurological), 66.7% of outcomes in canine patients and 44.4% in felines were considered satisfactory. In group II (orthopedic), 61% of outcomes in dogs and 66.7% in cats were considered satisfactory.Discussion: Physical therapy has many applications in small-animal practice. After spinal cord decompression surgery in dogs with IVDD, for instance, it helps maintain and recover motor and sensory function, and is considered safe and well-tolerated in dogs after thoracolumbar hemilaminectomy with disc fenestration. Physical therapy also plays an important role after surgical repair of fractures and dislocations, aiding recovery of range of motion and return to functional activity. The most probable explanation for the wide variation in number of physical therapy sessions can be explained by owners’ satisfaction with the level of recovery achieved by the animal, often leading to discontinuation of physical therapy. The high rate of unsatisfactory outcomes in feline patients can be explained by the type of injury (spinal trauma) and the degree of neurological dysfunction. Adult female dogs were most likely to be referred to the physical therapy sector, and the Dachshund and Poodle breeds were most prevalent. Patients in the neurological dysfunction group had the highest average duration and number of sessions. Massage, stretching, passive joint mobilization, and neuromuscular electrical stimulation (NMES) were the most commonly used modalities in all physical therapy protocols. Satisfactory functional recovery was achieved in more than 60% of cases in both groups. The absence of a control group and the lack of standardization of physical therapy modalities precluded a more definitive confirmation of the results obtained in terms of functional recovery.

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Section: Discussionunclassified

Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy

Colveiro

Rauber

Ripplinger

et al. 2020

Acta Scientiae. Vet.

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“…Femoral head and neck excision (FHNE) is a commonly performed salvage procedure for the diseased or injured coxofemoral joint in dogs and cats. [1][2][3][4][5][6] In cats, FHNE has been reported for the treatment of capital physeal fractures, coxofemoral luxations, acetabular fractures, osteoarthritis and femoral head and neck fractures. [7][8][9][10][11] The procedure was first developed in humans, called the Girdlestone excision arthroplasty for septic tuberculosis lesions, and was adopted into veterinary medicine decades later in dogs for the treatment of coxofemoral diseases.…”

Section: Introductionmentioning

confidence: 99%

“…2,5,8 An inadequate FHNE can cause pain and limb dysfunction due to continued bone contact between the acetabular rim and femoral neck, 2,3,5 and sciatic nerve damage or entrapment. [3][4][5]14 Currently, the standard of care is to assess adequacy of the excision with intraoperative palpation of the hip joint for bone contact, and postoperative radiographs consisting of standard orthogonal radiographic views of the pelvis (ventrodorsal and lateromedial). 15 Routine ventrodorsal pelvic radiographic views are obtained with the femurs in extension, with the stifles internally rotated.…”

Section: Introductionmentioning

confidence: 99%

Effects of Femur Position on Radiographic Assessment of Femoral Head and Neck Excision Completeness in Cats

Howser

Vinayak²,

Ward

et al. 2020

Vet Comp Orthop Traumatol

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Objective The aim of this study was to determine the effect of femoral position on radiographic assessment of completeness of femoral head and neck excision (FHNE) in cats. Study Design The study included 20 femurs from adult cats. Complete FHNE was performed on 10 femurs and incomplete excision consisting of inadequate excision of the distal medial femoral neck was performed on 10 femurs. The lesser trochanter was maintained in all femurs. Each femur was positioned through a predetermined set of eight radiographic views about the long axis. Sensitivity (SE), specificity (SP) and accuracy were calculated for each femoral position. Results Craniocaudal views of the femur in external rotation (30° and 45°) had the highest SE, SP and accuracy (SE: 97.5% and 97.5%; SP: 92.5% and 95%; and accuracy: 95% and 96%, respectively) followed by external rotation of 15 (SE: 92.5%, SP: 87.5% and accuracy: 90%) relative to standard craniocaudal (SE: 57.5%, SP: 72.5%, accuracy: 65%) and lateromedial (SE: 2.5%, SP: 0%, accuracy: 1%) radiographic views. Conclusions Evaluation of craniocaudal radiographic views with the femurs in external rotation can increase the ability to assess the adequacy of the FHNE in cats.

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“…Femoral head and neck ostectomy (FHNO) is a widespread salvage procedure for the treatment of hip osteoarthritis due to hip dysplasia in dogs. 1 Success of FHNO relies on the elimination of bone contact between the femur and the acetabulum, 2 and FHNO can improve limb function and reduce the pain of dogs with hip osteoarthritis. 3,4 However, FHNO leads to anatomical and biomechanical alterations of the hip joint, such as limb-length discrepancy and limitation in range of motion, which can result in abnormal gait and pain in some animals.…”

Section: Introductionmentioning

confidence: 99%

“…Femoral head and neck ostectomy (FHNO) is a widespread salvage procedure for the treatment of hip osteoarthritis due to hip dysplasia in dogs . Success of FHNO relies on the elimination of bone contact between the femur and the acetabulum, and FHNO can improve limb function and reduce the pain of dogs with hip osteoarthritis .…”

Section: Introductionmentioning

confidence: 99%

Custom acetabular prosthesis for total hip replacement: A case report in a dog with acetabular bone loss after femoral head and neck ostectomy

2019

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Objective To describe the application of a custom acetabular prosthesis (CAP) for total hip replacement (THR) in a dog 20 months after femoral head and neck ostectomy (FHNO). Study design Case report. Animal A 10‐year‐old, male, castrated, Labrador retriever with progressive lameness and pain after FHNO. Methods Acetabular bone stock was assessed as insufficient for conventional THR, so a biflanged CAP was designed and three‐dimensionally printed in titanium to bridge the bone defect. The CAP had a porous surface for long‐term biologic fixation on the backside and was anchored to the ilium and ischium with screws. A polyethylene cup was cemented into the CAP, and a bolted cementless femoral stem was inserted. Results The loss of the conventional anatomic landmarks complicated intraoperative orientation and led to eccentric reaming and 5‐mm malalignment of the CAP. Reduction of the prosthetic joint was difficult because of periarticular fibrosis, loss of functional muscle length, and thickness of the CAP, and intraoperative shortening of the stem neck was required. Postoperative complications included sciatic neurapraxia, which resolved with time and conservative management. Absence of pain and improvement of range of motion were observed at clinical examination 12 months after surgery; however, moderate hind limb lameness persisted due to muscle tension. No evidence of implant loosening was noted on radiographs acquired 24 months after surgery. Conclusion Femoral head and neck ostectomy with poor functional outcome was ameliorated by using a CAP in this dog. Clinical significance Use of a CAP can be considered to treat acetabular defects in dogs.

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Femoral Head and Neck Excision

Cited by 39 publications

References 27 publications

Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy

Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy

Effects of Femur Position on Radiographic Assessment of Femoral Head and Neck Excision Completeness in Cats

Custom acetabular prosthesis for total hip replacement: A case report in a dog with acetabular bone loss after femoral head and neck ostectomy

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